Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan.
School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Sci Rep. 2023 Aug 23;13(1):13732. doi: 10.1038/s41598-023-40755-9.
Intraoperative teaching is a challenging task. The briefing-intraoperative teaching-debriefing (BID) model, which is based on guided discovery learning at limited time intervals, has rarely been investigated. This study validated the benefits of the modified BID model on medical clerks. This study involved 37 first-year medical clerks enrolled from September 2019 to May 2020. Every learner scrubbed in one the totally implantable venous access device placement surgery and completed a pre-/posttest survey on surgical procedures and associated anatomy conducted through an intraoperative teaching questionnaire. Of these participants, 15 merely observed throughout the entire procedure (observation group), whereas the remaining 22 performed simple suturing under supervision (suturing group). All participants underwent an objective structured assessment of simple interrupted suturing skills at the end of the observership. Correlations were tested using a two-tailed paired t-test, with a p-value < 0.05 indicating statistical significance. The response rate was 100% and participants could reconfirm the precise venous access, catheter tip location, and suture materials for portal fixation after totally implantable venous access device placement (p < 0.05). Although a relatively higher satisfaction of the intraoperative teaching environment and educator attitude was reported in the suturing group than in the observation group, the difference in scores on the objective structured assessment was not statistically significant (8.7 ± 1.8 vs. 7.2 ± 3.7; p = 0.104). Our findings indicate that the modified BID model with hands-on experience is a practicable module for matching intraoperative teaching and learning via learning perception enhancement for medical undergraduates during totally implantable venous access device placement.
术中教学是一项具有挑战性的任务。基于限时引导发现学习的备课-术中教学-课后总结(BID)模式很少被研究。本研究旨在验证改良 BID 模式对实习医生的益处。本研究纳入了 2019 年 9 月至 2020 年 5 月期间的 37 名一年级实习医生。每位学习者均参与完全植入式静脉输液港置管术,并通过术中教学问卷完成手术流程和相关解剖的术前/术后测试。其中,15 名参与者仅在整个过程中观察(观察组),而其余 22 名参与者在监督下进行简单缝合(缝合组)。所有参与者在观察结束后均接受了简单间断缝合技能的客观结构化评估。使用双侧配对 t 检验测试相关性,p 值<0.05 表示具有统计学意义。应答率为 100%,参与者在完全植入式静脉输液港置管后能够重新确认确切的静脉通路、导管尖端位置和用于门脉固定的缝合材料(p<0.05)。尽管缝合组报告的术中教学环境和教育者态度满意度相对较高,但客观结构化评估中的分数差异无统计学意义(8.7±1.8 比 7.2±3.7;p=0.104)。我们的研究结果表明,带有实践经验的改良 BID 模式是一种可行的模块,可通过增强学习感知来匹配实习医生在完全植入式静脉输液港置管期间的术中教学和学习。